EP1056401A1 - Dispositif pour traiter des tissus corporels au moyen d'ultrasons - Google Patents

Dispositif pour traiter des tissus corporels au moyen d'ultrasons

Info

Publication number
EP1056401A1
EP1056401A1 EP99907538A EP99907538A EP1056401A1 EP 1056401 A1 EP1056401 A1 EP 1056401A1 EP 99907538 A EP99907538 A EP 99907538A EP 99907538 A EP99907538 A EP 99907538A EP 1056401 A1 EP1056401 A1 EP 1056401A1
Authority
EP
European Patent Office
Prior art keywords
hollow probe
jaw
cutting blade
ultrasound
tissue
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP99907538A
Other languages
German (de)
English (en)
Other versions
EP1056401B1 (fr
Inventor
Pavel Novak
Rudolf Henes
Beat Krattiger
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Storz Endoskop GmbH
Original Assignee
Storz Endoskop GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Storz Endoskop GmbH filed Critical Storz Endoskop GmbH
Publication of EP1056401A1 publication Critical patent/EP1056401A1/fr
Application granted granted Critical
Publication of EP1056401B1 publication Critical patent/EP1056401B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/295—Forceps for use in minimally invasive surgery combined with cutting implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00353—Surgical instruments, devices or methods for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A61B2017/320074—Working tips with special features, e.g. extending parts blade
    • A61B2017/320075—Working tips with special features, e.g. extending parts blade single edge blade, e.g. for cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system

Definitions

  • the invention relates to a device for treating body tissue by means of ultrasound, with a generator and with a device for transmitting the ultrasound to the tissue, which device has a hollow probe for suctioning off the treated tissue.
  • a device for treating body tissue by means of ultrasound with a generator and with a device for transmitting the ultrasound to the tissue, which device has a hollow probe for suctioning off the treated tissue.
  • Such a device is described, for example, in company brochure 9/95 "SONOTOM 110, ultrasound aspirator” from Berchthold GmbH + Co, Medizin-Elektronik, Tuttlingen, Germany.
  • Ultrasound is not only used in the diagnostic field to visualize body structures with different densities, but also for therapeutic purposes.
  • the ultrasound is either applied from the outside through the skin or with appropriate laparoscopic instruments, possibly under endoscopic control, inside the body directly at the site of the tissue to be treated.
  • the ultrasound treatment firstly heats up the tissue and thus denatures it, the so-called (thermo) coagulation.
  • the ultrasound has a mechanical effect in the form of so-called cavitation.
  • Sound waves propagate in a medium as periodically changing density fluctuations in the medium.
  • a volume element of the medium is alternately compressed (overpressure) and expanded (underpressure).
  • the negative pressure in a liquid for example in the cytoplasm of the cells or in the tissue fluid, can lead to the formation of vapor bubbles, as a result of which cells and tissue are destroyed.
  • Such a therapeutic ultrasound treatment is suitable for disintegrating, ie dissolving, soft tissues such as adipose tissue.
  • Ultrasonic waves in the range of 26 kHz are generally used.
  • the coagulated and / or disintegrated tissue is suctioned off by a tubular hollow probe, with a rinsing device for rinsing mostly also being provided.
  • the rinsing liquid is passed through a cavity between the hollow probe and an outer shaft. The line or tissue remnants mixed with the rinsing liquid are sucked off by the hollow probe.
  • Ultrasound treatments are used primarily for the destruction of tumorous tissue.
  • Ultrasound treatments are used in particular in liver surgery since this technique can be used to skeletonize, i.e. from an organ like the liver only parts of tissue can be detached without cutting or destroying blood vessels of the organ.
  • Such an “ultrasound-driven” surgical knife for laparoscopic applications is described, for example, in WO 93/14708.
  • a knife is slidably arranged inside a shaft from which it can be pushed out during the operation.
  • ultrasonic energy is transferred directly and exclusively to the knife, which stimulates it to vibrate.
  • this surgical cutting device A therapeutic application of ultrasound to disintegrate tissue is not possible with this surgical cutting device. There is also no possibility of removing the cut tissue from the surgical field. In addition, this device is limited to diameters larger than one centimeter.
  • DE 40 42 435 C2 discloses an ultrasound treatment device with a handpiece, which has an ultrasound oscillator, and a plurality of probes, which can be connected to the handpiece. This makes it possible to provide an ultrasound device which, with low purchase and maintenance costs, is simultaneously suitable for a wide variety of purposes.
  • An ultrasonic hollow probe is known from EP 0 384 672 A2, in which the distal suction opening changes in shape and size. can be changed in order to obtain an optimal suction power for suctioning the treated tissue.
  • an ultrasound instrument is known, the distal end of which is formed like a spoon.
  • a central flushing channel serves to supply a liquid to the distal end, which is shaped like a spoon.
  • US Pat. No. 5,188,102 describes a surgical knife which can be vibrated by ultrasound and which is provided in the center with a flushing channel via which a flushing liquid, in particular at an angle of 5 to 90 ° with respect to the cutting plane, can be fed to the distal end .
  • EP 0 695 535 A1 describes an ultrasound-operated gripping instrument that can grip the tissue that has been detached by the ultrasound.
  • an ultrasound operated device which is suitable for cutting and coagulating.
  • a clamping device is provided at the distal end, via which the tissue to be coagulated can be brought between a movable jaw part and a stationary jaw part.
  • the object on which the invention is based is achieved in a device of the type mentioned in the introduction in that a cutting blade is provided in the region of the distal end of the hollow probe.
  • the hollow probe is only used to soak up and remove the coagulated and liquefied cell and tissue components, possibly also to inject rinsing liquid into the operating field and soak it up again.
  • a multifunctional medical instrument is made available in a simple manner, with which the soft tissue components are disintegrated, suctioned off by ultrasound and, at the same time, firmer, more insensitive to ultrasound Tissue parts can be cut off and also vacuumed off.
  • the effect is exploited that the distal end of the hollow probe lying in the operating field is excited to vibrate even in the case of a therapeutic ultrasound application.
  • the vibrating cutting blade has excellent cutting properties, even if the blade itself is relatively blunt.
  • the functions of the device according to the invention suitable for the destruction of tissues are further supported by the heat generation of the therapeutic ultrasound waves, so that it is possible with a single instrument to disintegrate simultaneously by ultrasound treatment of the tissue, to cut off and / or scrape off the cutting blade and also to coagulate , whereby detached line or tissue components are removed from the operating field.
  • the cutting blade can also be used to separate solid or soft tissue components, e.g. for separating adipose tissue from subcutaneous tissue.
  • the device according to the invention can be used as a cutting and suction device.
  • the device according to the invention thus combines several functions which are required directly in the operating field in the above-mentioned applications and thus saves the surgeon from having to frequently change the surgical devices. Such operations are thus much easier and faster to perform than was previously possible.
  • the multifunctionality of the device is achieved with very simple means, namely by equipping the proximal hollow probe end with a cutting blade.
  • the cutting blade is an integral part of the hollow probe wall. This measure has the advantage that the cutting blade can be manufactured particularly easily, namely simultaneously with the hollow probe. In addition, good resistance is achieved by this measure, since means for attaching the cutting blade to the distal end of the hollow probe are eliminated.
  • the cutting blade is designed as an extension of the hollow probe wall.
  • the cutting blade can be flat or curved, it can taper or widen, depending on the desired application.
  • the design of the cutting blade as an extension has the essential advantage that the device according to the invention has a further function, namely that it can also be used as a spatula.
  • the cutting blade which can be relatively blunt, can be used as a spatula surface for scraping tissue when the ultrasound source is switched off.
  • the scraped tissue is on the flat extension in a position directly in front of the opening of the hollow probe and can thus be suctioned off immediately.
  • the extension vibrates and then has the effect of a sharp cutting blade.
  • the cutting blade is advantageously exposed and reaches the tissue that is to be cut off particularly well.
  • the distal end of the hollow probe has a device for gripping and / or severing with a first and a second jaw.
  • This measure has the advantage that the device according to the invention is expanded by two further functions which are often required in operations in which tissue has to be removed: grasping, for example, vessels, nerves or the like, and severing such tissue structures.
  • grasping for example, vessels, nerves or the like
  • severing such tissue structures.
  • the gripping and severing function is particularly necessary when particularly firm tissue components have to be removed or cut or separated.
  • the device according to the invention becomes a clamp or clamp by means of the two jaws attached to the distal end of the hollow probe, with which blood vessels can also be clamped without being severed.
  • the first jaw of the device for gripping and / or severing is formed by the cutting blade.
  • the second jaw of the device for gripping and / or severing can be shifted along the longitudinal axis of the hollow probe, consists of a superelastic material and is bent away from the first jaw in a state pushed out of the hollow probe and moves when it is pulled into it Hollow probe towards the first jaw.
  • the movement of the jaw along the longitudinal axis can be caused, for example, by an actuating element that can be operated from the proximal side of the device by pulling.
  • the superelastic material can be, for example, Nitinol, a nickel-titanium alloy, which is a so-called "memory material". This material has the property of always returning to its original shape even after deformation.
  • This measure has the advantage that the device for gripping or severing can be manufactured and actuated in a particularly simple manner without the need for joints, axes of rotation or the like.
  • the bend of the second, displaceably mounted jaw can be oval or flattened or have more complicated bends and curvatures, depending on the desired application.
  • a guide and slide element for the second jaw is provided inside the hollow probe.
  • the guiding and sliding element can be made of Teflon, for example. This has the further advantage that any welding of the second jaw to the hollow probe that occurs under certain circumstances is prevented when ultrasound is activated, which is accompanied by the development of heat.
  • the second jaw of the device for gripping or severing can be spread apart from the first jaw by pivoting.
  • the second jaw By pivoting the jaw about a transverse axis, the second jaw is thus folded away from the first jaw into an open position of the device for gripping and / or severing, or is closed again in the direction of the first jaw.
  • the hollow probe has an outer shaft to which the second jaw is pivotably anchored.
  • This measure has the advantage that the outer shaft can be used for fastening or mounting the second jaw.
  • the pivoting can be actuated, for example, with a rod or cable pull, which is also provided within the outer shaft wall. 12
  • the mounting of the second jaw can also be such that a displacement of the outer shaft causes the second jaw to pivot.
  • the outer shaft advantageously protects the hollow probe against mechanical stress.
  • the rinsing liquid is supplied in the space between the outer shaft and the hollow probe.
  • the outer shaft consists of an upper half and a lower half, which are displaceable relative to one another on a dividing line along the longitudinal axis of the hollow probe, displacement of the half on which the second jaw is anchored, pivoting of the second Cheek causes.
  • This measure has the advantage that the relative displacement of the outer shaft halves from one another exerts the necessary tension on the second jaw in order to pivot it relative to the first jaw.
  • the device for gripping and / or separating has a tube with an extension, which is received in the interior of the hollow probe, the hollow probe and tube being rotatable relative to one another, and the 13
  • the extension works together with the cutting blade of the hollow probe.
  • This measure has the advantage that the device is designed as a turning tongs.
  • rotating the hollow probe and the inner tube relative to each other this can be done by twisting either the inner tube or outer tube or both tubes to each other, tissue parts can be brought between the extension and cutting blade and either gripped or even cut, so that the rotary tongs as a rotating pliers or as Rotary cutting pliers can work.
  • a particularly slim design is formed by this geometry, so that there are no jaws projecting laterally over the outer circumference of the outer shaft when opening.
  • This configuration will be used in particular when relatively small parts are to be gripped or separated.
  • the extension of the inner tube comes to rest closely with the cutting blade in a rotational position, so that both extensions work as a compact component.
  • This measure has the advantage that in this rotating state the hollow probe can be operated as if it had no gripping device, since the two tubes are then twisted relative to one another in such a way that their extensions work as one component. In this rotational position, this compact component can then either work as a cutting blade and / or as a spatula. 14
  • the longitudinal edges of the extensions are blunt.
  • This measure has the advantage that the pliers work specifically as gripping pliers and there is no cutting of the gripped parts.
  • the longitudinal edges of the extensions are sharp-edged.
  • This measure has the advantage that, due to this configuration, the device works specifically as cutting pliers.
  • the hollow probe can be subjected to high-frequency current (HF current).
  • HF current high-frequency current
  • This measure allows the device according to the invention to have the further function, namely to be able to be used for HF coagulation, that is to say, for example, to rapidly and efficiently clear up heavily bleeding vessels by applying HF currents.
  • Figure 1 is a schematic representation of a device according to the invention for the treatment of body tissue by means of ultrasound.
  • FIG. 2 shows a greatly enlarged side view of the distal end of a first exemplary embodiment of a hollow probe of the device according to the invention
  • FIG. 3 is a top view of the distal end of the hollow probe of FIG. 2;
  • Fig. 4 is a section along the line IV-IV in Fig. 2;
  • FIG. 5 shows a longitudinal section through the distal end of a further exemplary embodiment of a hollow probe of a device according to the invention with a device for gripping, specifically in an open operating position of the gripping device;
  • FIG. 6 shows a longitudinal section corresponding to FIG. 5, but in a closed operating position of the gripping device
  • FIG. 7 shows a plan view of the distal end of a further exemplary embodiment of a hollow probe of a device according to the invention with a gripping device in a closed operating position and with an outer shaft;
  • FIG. 8 shows a side view of the distal end corresponding to FIG. 7, namely in a closed operating position of the gripping device
  • FIG. 9 shows a side view corresponding to FIG. 8, but in an open operating position of the gripping device
  • FIG. 10 shows a longitudinal section of a further exemplary embodiment of a distal end of a hollow probe which is designed as a turning tongs;
  • FIG. 11 shows a section along the line XI-XI in FIG. 10, the projections being shown in a diametrically opposite position;
  • FIG. 12 shows a section comparable to FIG. 11, in which the extension of the inner tube is rotated counterclockwise by approximately 45 °; 17
  • FIGS. 11 and 12 show a sectional illustration comparable to FIGS. 11 and 12, in which the extension of the inner tube is rotated counterclockwise by approximately 90 °;
  • Fig. 14 is a representation comparable to the representation of Figs. 11 to 13, in which the extension of the inner tube is rotated by 180 ° with respect to the representation of Fig. 11 and comes to rest on the cutting blade of the hollow probe.
  • FIG 1 shows an apparatus for the treatment of body tissue by means of ultrasound, which is generally designated by the reference number 10.
  • the device 10 has a generator 12 and a device 13 for transmitting the ultrasound to body tissue.
  • the device 13 has an ultrasound transducer 15 which generates the ultrasound.
  • the generator 12 is equipped with two display fields 14, a peristaltic pump 16 and with sockets 18.
  • a supply line 20 is led through a flexible hose 22, which starts from the pump 16.
  • the hose 22 and the supply line 20 are connected to a handle 26 and end in a hollow probe 28.
  • the hollow probe 28 has a distal end 30, the design of which can be seen better in FIGS. 2 to 4.
  • a flushing medium is guided between an outer shaft (not shown here) and the hollow probe 28 to the distal end 30. 18th
  • the hollow probe 28 has a channel 32 for aspirating liquid and tissue components.
  • the hollow probe wall 34 ends in a flat, flat extension 36, the edges 38 of which work as cutting edges, and thus represents a cutting blade 39.
  • the transmitted ultrasound disintegrates, in particular, soft but not yet firm tissue and liquefies it.
  • the tissue is also coagulated by the heat generated by the ultrasound.
  • the ultrasound conducted through the hollow probe 28 causes the distal end 30 of the hollow probe 28 to vibrate. This vibration moves the cutting blade 39 and thus cuts even firm tissue efficiently and quickly.
  • the cutting blade 39 has a rounded, sharp end edge. As indicated by a dash-dotted line, this can also be angular and blunt. 19
  • FIGS. 5 and 6 relate to a further embodiment of a hollow probe for the device 10 according to the invention. Only the distal end of the hollow probe, which is generally designated by 40, is shown.
  • the distal end 40 has a device for gripping 42, which is constructed from a first jaw 43 and a second jaw 44.
  • the first jaw 43 is an extension of the hollow probe wall 45 and has a cutting blade 46.
  • the second jaw 44 which consists of a superelastic material with shape memory, a so-called memory metal, is slidably arranged in the hollow probe lumen 47.
  • the memory metal is, for example, a nickel-titanium alloy. It protrudes from the hollow probe lumen.
  • the second jaw 44 is guided in the hollow probe lumen 47 by a sliding and guiding element 52 made of Teflon.
  • FIG. 5 shows an open operating position of the device for gripping 42.
  • the second jaw 44 is pushed far out of the hollow probe lumen 47 and, due to the memory effect, bends upwards and backwards to form a protuberance 48, projecting beyond the proximal end 40.
  • the jaw 44 is bent and folds forward in the direction of the arrow 55. 20th
  • Fig. 6 it is the closed operating position or gripping position of the device 42 for gripping. In this position, tissue layers, veins or nerves, for example, can be gripped and held firmly.
  • a hump 49 of the second jaw 44 forms a stop, so that a complete retraction of the second jaw 44 into the hollow probe lumen 47 is prevented.
  • FIGS. 7 to 9 A further exemplary embodiment of a hollow probe according to the invention with a device for gripping is shown in FIGS. 7 to 9.
  • a distal end of such a hollow probe is generally designated 60.
  • a device 61 for gripping is provided, which consists of a first jaw 64 and a second jaw 66.
  • the first jaw 64 is formed from an extension of the hollow probe wall 67 and has a cutting blade 68.
  • the second jaw 66 consists of a tongue 69, from which two brackets 71 protrude proximally, which encompass the hollow probe wall 67 and an outer shaft 70 in which the distal end 60 is axially displaceably mounted.
  • the brackets 71 are rotatably fastened in corresponding receptacles in the hollow probe wall 67 via axis pins 72.
  • the brackets 71 have at their ends radially inwardly projecting pins 75, which slidably engage in scenes 76 of the outer shaft 70.
  • the wall of the outer shaft 70 also has cutouts 78 which extend in the upper third of the outer shaft 70 along the longitudinal axis.
  • the outer shaft 70 is maximally displaced distally. A pressure is exerted on the second jaw 66 via the pin 75 engaging in the backdrop 76, so that gripping and holding of tissue parts, vessels or the like. is possible in this position.
  • the pin 75 moves in the backdrop 76 and the second jaw 66 is pivoted upward about its axis of rotation A, which is defined by the pin 72.
  • the pin 72 runs into the recess 78. 22
  • the second jaw 66 In the operating position shown in FIG. 9, the second jaw 66 is folded upwards by 90 ° and releases the suction channel, so that suction and rinsing can be carried out without problems.
  • the second jaw 66 can also be pivoted up to 180 °, so that it fits snugly along the outside of the outer shaft. The second jaw 66 can remain in this position if temporarily no gripping function of the jaws is desired or necessary.
  • the hollow probe 28 is provided with an extension 84 at the outer end.
  • the extension 84 is formed in that a part of the tube wall is removed at the distal end 80, so that only a certain circumferential section of the tube wall has remained, as can be seen in particular from the sectional view of FIG.
  • An inner tube 86 is inserted into the hollow probe 28, the outer diameter of which corresponds approximately to the clear inner diameter of the hollow probe 28.
  • the inner tube also has an extension 88 at the distal end, which is created by removing part of the tube wall.
  • this extension 88 has a flat inside 90, as can be seen in particular from the sectional illustration in FIG. 11.
  • the hollow interior of the inner tube 86 forms a channel 92 which is used for suction. 10 and 11, the extension 84 is diametrical 23
  • the hollow probe 28 can be operated as an ultrasound aspirator probe.
  • the inner tube 86 can be rotated relative to the tube 82, as can be seen from the image sequence from FIG. 11 to FIG. 14.
  • the extension 84 has sharp longitudinal edges 85, and the extension 88 likewise has sharp longitudinal edges 89.
  • edges are blunt, they can work as parts of a rotating gripper.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Mechanical Engineering (AREA)
  • Biomedical Technology (AREA)
  • Dentistry (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif pour traiter des tissus corporels au moyen d'ultrasons, ledit dispositif comprenant un générateur (12) et une unité (13) pour transmettre les ultrasons au tissu. Cette unité (13) présente une sonde creuse (28) pour aspirer le tissu traité. L'invention est caractérisée en ce qu'une lame de coupe (38) est prévue au niveau de l'extrémité distale (30) de la sonde creuse (28).
EP99907538A 1998-02-18 1999-02-11 Dispositif pour traiter des tissus corporels au moyen d'ultrasons Expired - Lifetime EP1056401B1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE19806718A DE19806718A1 (de) 1998-02-18 1998-02-18 Vorrichtung zur Behandlung von Körpergewebe mittels Ultraschall
DE19806718 1998-02-18
PCT/EP1999/000892 WO1999042040A1 (fr) 1998-02-18 1999-02-11 Dispositif pour traiter des tissus corporels au moyen d'ultrasons

Publications (2)

Publication Number Publication Date
EP1056401A1 true EP1056401A1 (fr) 2000-12-06
EP1056401B1 EP1056401B1 (fr) 2004-11-03

Family

ID=7858134

Family Applications (1)

Application Number Title Priority Date Filing Date
EP99907538A Expired - Lifetime EP1056401B1 (fr) 1998-02-18 1999-02-11 Dispositif pour traiter des tissus corporels au moyen d'ultrasons

Country Status (4)

Country Link
US (1) US6436114B1 (fr)
EP (1) EP1056401B1 (fr)
DE (2) DE19806718A1 (fr)
WO (1) WO1999042040A1 (fr)

Families Citing this family (214)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19806718A1 (de) 1998-02-18 1999-08-26 Storz Endoskop Gmbh Vorrichtung zur Behandlung von Körpergewebe mittels Ultraschall
US6214023B1 (en) * 1999-06-21 2001-04-10 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instrument with removable clamp arm
WO2001035812A2 (fr) * 1999-11-15 2001-05-25 Misonix Incorporated Lame tranchante a ultrasons avec refroidissement
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EP1056401B1 (fr) 2004-11-03
US6436114B1 (en) 2002-08-20
WO1999042040A1 (fr) 1999-08-26
DE19806718A1 (de) 1999-08-26
DE59910994D1 (de) 2004-12-09

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